Hi everyone,
Feeling kind of depressed. I had written before about how I was fighting with myself about the possiblity of going on Met and said that if my next A1C was higher than the last that I would be ok with going on it. Well, it was higher this time and guess what? I'm not ok. I feel as if I have fought SO hard with my diet and exercise and have been watching this number go higher and higher and higher. 18 mos ago my A1C was 5.3. Six months ago, 5.6%, today 5.9% and this is after having lowered my carb intake even more and increased my exercise to 6 times a week. I continue to lose weight as, I am 96 pounds. (I must mention that my fasting has come down. Last time it was 90, this time, 85). I cannot afford to cut anymore carbs, nor can I afford to lose anymore weight. I feel like crap a lot of the time. My muscles continuously spasm (neuropathy has been ruled out), I am thirsty a lot (bit it's more of a dry mouth thirst) and worst of all, I am starving all the time, no matter what I eat. The doc thinks that my body has possibly gone into "starvation mode." I guess my big thing with it is this: I feel as if it is progressing very quickly. Does this mean that it will continue to progress even on the Met to the point where in just a few more yrs I'll be on insulin? I am only 35. Will the met slow the progression down? Will I not have to be SO VERY strictly regimented that I will be able to have a little more wiggle room with diet? I eat the same things almost every single day!!! BLAH! I thought I would be able to take it better, but I think this just drives it home that it is indeed REAL and it will NEVER go away and that it will get worse. I thought for sure I'd be able to control it with diet and exercise, but apparently that's not the case. I could use some advice about Met and how this will greatly improve my life....there are lots of soggy shoulders at work here today...Thanks.

The Met may help. I say may because it doesn't work for everyone. And if it doesn't, there are others. Januvia, Byetta and others. You will find one that helps.

I am also a firm believer in what stress does. You may be so obsessed with it, as I was, that this actually makes things worst. Stress absolutely increases insulin resistance. As a matter of fact, I have noticed my levels are better since I put on a bit of weight and relaxed more. If your body is in 'shock' or starvation mode, this can cause your levels to rise and increase your insulin resistance.

This week I am off to see the doc to find out how I did on the 1AC. If he choses to put me on meds, I will gladly accept it, knowing I did everything I could and knowing I will be able to see the difference.

I have even toyed with asking him to try insulin to improve my morning levels. The rest of the time I do fine, but mornings are tough. I don't mind the idea of using insulin, because if it will prolong my pancreas, so be it.

Don't sweat the meds. We all have our weak points. I'll take this diabetes over MS, cancer....and a lot of other nasty stuff.

Hi lilbit1973. I'm sorry to hear about how you're feeling though I kind of think all us diabetics kind of have those moments. I've had moments where I've felt exactly like you. In fact, I've felt just like giving up all together with my strict diet and exercise regimen. I'll say to myself, hell I've been health conscious all my life and apparently that didn't prevent this from happening! But then I remind myself (or a family member will remind me) that the last thing I want is to deal with the side effects of poorly managed diabetes, and that I want to stick around long enough to watch my kid grow up.

I think I mentioned to you that my husband was diagnosed a few months after me. He's been especially strict with his diet and exercise. (The difference between him and I is that I've always been a health nut but he never was until he got the diagnosis). He's been exercising like crazy, limiting his carbs, and has lost a ton of weight. Despite that, his postprandials seem to be going up to and it's very frustrating for both of us. I think eventually he will need meds too. One point here, BTW, is that we are concerned that the weight loss might also mean loss of muscle mass...which affects insulin sensitivity.

I, like you, also get scared about the fact that we've been diagnosed at a relatively young age, which means we have a longer time to live with this and deal with the potential repercussions. So scary, I really do get scared, thinking we're all trying so hard to control this and our best efforts do not seem to make a big difference sometimes. Sigh.

Anyhow, I guess there's always hope that a cure/better treatment will be found. I thought I heard something about a diabetes vaccine for infants? But that's for Type I. Anyhow, there's tons of research out there being done.

Hi Uma Anne,
I am so glad to hear from you. I am sorry about your husband. I know how it feels though. This has got to be one of the most frustrating diseases there is. To fight SO hard and to try so hard and you lose no matter what you do. Tell me, have you seen a difference in your sugars with the Met? I remember the last time we spoke you hadn't really seen a difference. Will my feeling like crap all the time go away, if it's diabetes related that is? The hunger has got to be the worst. Will I be able to broaden my diet even just a little bit more than I am now? Will it continue to progress just as fast on the meds or will the meds slow the progression down for a while? A vaccine for type 1????? Really???? Are they using it yet? That is one of my biggest fears about my child. The next, him being a t2. He is a carbon copy of me. On a positive note, according to the doctor today, it's the people that don't take care of themselves, that just do whatever they want, that end up with the complications and the people like us, who live relatively long, healthy lives. I hope that is true. I just want to see my son grow up. I have a GTT in the morning and she's also drawing an insulin level. Based on those numbers, she will decide on the Met or not. Of course I will draw my own 2hr finger stick just because I want to know. I will keep you posted. Thanks for your words of encouragement. I'd like to hear how the Met is working for you when you get a second. BTW, how rare is this lactic acidosis with Met????

I asked my doc about this. It is extremely rare. If you drink alcohol a lot, it makes the risk higher. I asked the doc to define 'a lot' because I like my beer on weekends and he basically said it would be a problem if you are drinking 3 a day or more.

I spoke to 2 pharmacists who had prescribed it thousands and thousands of times and never had 1 single case.

Thanks Ito! That's good to know. Ok, I just got back from my 2hr GTT test. They just drew the blood and I, just because I wanted to know, drew a fingerstick. My meter read 153 two hours after the drink. I know there is a margin of error with the meters, but I don't think it would be THAT big where theirs would read over 200 and mine wouldn't even be close. In fact, the last fasting they drew and I fingerstuck at the same time was only 3 points different. Here is my question; if I am still considered pre-diabetic, why is my A1C continuing to rise even after cutting carbs and increasing exercise???

Thanks Ito! That's good to know. Ok, I just got back from my 2hr GTT test. They just drew the blood and I, just because I wanted to know, drew a fingerstick. My meter read 153 two hours after the drink. I know there is a margin of error with the meters, but I don't think it would be THAT big where theirs would read over 200 and mine wouldn't even be close. In fact, the last fasting they drew and I fingerstuck at the same time was only 3 points different. Here is my question; if I am still considered pre-diabetic, why is my A1C continuing to rise even after cutting carbs and increasing exercise???

Wow that is great!!!! You see, you are winning battles!!!! Go girl !!!!

There can be a difference between capillary/venous/whole blood/plasma....bla bla bla, but I unless your meter is way off, you should be good.

It will be interesting for you to see your insulin levels.

I can't explain why your 1ac is rising, but I would bet you are putting excess stress on your body due to eating patterns, worry, weight loss. This stress will raise your glucose levels and increase insulin resistance. Guaranteed. It may not explain everything, but I am a firm believer it contributes.

It took me almost 2 years to get my stress under control. I got into a spiral of worrying, bad eating (too few carbs), over excercising, worst results, more worrying, less eating, excercising too much.....

I can honestly tell you Ito, that my A1C was LOWER when I was eating MORE carbs!!!! Go figure! Maybe I should go back to eating more carbs, since I am exercising 5-6 times a week. As is, I am eating 30g per meal and 15g per snack, but I always thought that more than that was too much. I have been suffering from this weight loss continuously and muscle spasms for almost 2 years now and I am wondering if maybe it's pulling nutrients from the muscles, hence the weight loss and spasms???? I don't know. Maybe I am stressing my body out too much. I get all of my results on Friday. So what does the 153 ish mean??? That I am still considered "pre-diabetic?" The doc is having me keep a food journal for her and she wants to see where I can add more calories in b/c she doesn't think I am getting enough. Will let you know how this all turns out.
Thanks again!

I can honestly tell you Ito, that my A1C was LOWER when I was eating MORE carbs!!!! Go figure! Maybe I should go back to eating more carbs, since I am exercising 5-6 times a week. As is, I am eating 30g per meal and 15g per snack, but I always thought that more than that was too much. I have been suffering from this weight loss continuously and muscle spasms for almost 2 years now and I am wondering if maybe it's pulling nutrients from the muscles, hence the weight loss and spasms???? I don't know. Maybe I am stressing my body out too much. I get all of my results on Friday. So what does the 153 ish mean??? That I am still considered "pre-diabetic?" The doc is having me keep a food journal for her and she wants to see where I can add more calories in b/c she doesn't think I am getting enough. Will let you know how this all turns out.
Thanks again!

If you're 85lbs you can't have much muscle and probably very very ittle fat. Not good for your insulin sensitivity. If your body is in 'starvation' mode, you are probably pumping out excess cortisol which will increase your insulin resistance and glucose levels. Also, if this is the case, you will not be adding muscle as quickly as you could. If this is the case you are probably not getting the benefit of the excercise. Do a search on cortisol and muscle or body building. I know you're not competing with Arnold, but what you will find does relate to people who are excercising and not eating properly. Then do a search on cortisol and insulin resistance. Throw in a search on cortisol and stress.

I understand why you want to go easy on the proteins, but I never quite understood why you can't get more calories from good fats. For example when I need calories that won't raise my glucose levels fast I eat a couple of teaspoons of peanut butter. Nuts are great for high calorie snacks. There was a good article on a health site I can't mention on the benefits of peanut butter for diabetics. Between nuts and dark chocolate I have no problem rounding off my calorie count. I'm getting a craving for almonds just writing this.

You have to get your body out of starvation mode if that's what's going on. Once I dropped 15lbs by excess excercise and I put myself in that spiral of bad sugar levels, work harder, get worst results. The DRs were useless in my case. A buddy of mine who body builds helped me more than the doc. But it took a while to get into an improving cycle. And while doing it, sometimes it's best to put one's meter away.

lilbit,
There have been a lot of discussions on this board about T2, and I'm pretty sure you've been on some threads where we've discussed how this disease can be progressive, no matter what you do.

If I may make a suggestion...instead of looking at this like you've "lost the battle"...think of the larger picture as a war...and you must win the war. To win a war you must use every weapon at your disposal. You're already using diet and exercise, and should keep doing that as it'll still help, but you need some bigger guns now. The bigger guns are oral medications. As Itotito pointed out in one of his replies, there are lots of oral medications now, and one of them is certain to work for you.

One other thing occurs to me, Lilbit...have you been tested lately for GAD antibodies? I'm wondering if it's possible that, rather than T2, you may actually have LADA (sometimes referred to as T1.5)...this is a very slow onset of T1 in adults. Sometimes it can take a year or more for the antibodies to show up, but a GAD antibody test at this point would seem to be in order, especially since you are definitely not overweight, continue to lose weight, and aren't eating a lot of carbs. You might want to ask for a C-peptide test as well.

Sam - what would the C-peptide test say? I'm in the same boat as lilbit. They have not tested for GAD but my C-peptide was on the lowest side of normal and the internist seems to think this is fine. My fasting is in the 80s now (from 101) and I have lost weight (weigh 92 pounds at present) but I don't eat a lot of carbs as 30+ leaves me with a post 2 hr around 150-160 so I try to stay under 30 per meal. My fasting insulin was also very low (taken by another doc who also said that was normal). I exercise regularly. Prior to changing my diet (and the pre-diabetic dx) I was dizzy and exhausted all the time.

I feel like I'm very much like lilbit and am anxious to see what her doc says about the insulin level..

Last edited by LilliTN; 09-24-2008 at 03:29 PM.
Reason: clarify weight as what I weigh not how much I lost

I will let you know how the insulin level comes out. I have to say that I was VERY surprised to see a reading of 153 2 hrs after drinking the GTT drink. Especially, when I have seen readings higher than that from eating a somewhat large sweet potato, 1/2 can green beans and a pork chop! I will ask the doctor about the LADA and the GAD & C-peptide. I did get both of those tests done about 2 yrs ago and both were normal. The doc is having me keep a food journal too to see if maybe I'm not eating enough and said something about the body pulling nutrients from the muscles. Would that make glucose levels higher??? This disease is so baffling.

I was of the belief that if you aren't getting a decent amount of carbs to burn for fuel your body starts burning muscle. For a while I was checking ketones with the little strips. I'd had a UTI a year ago and they did a urinalysis and remarked how high they were then. I didn't connect it to anything other than UTI. Had bought some strips myself then to test at home as a follow up and I remembered my grandfather had to do it too as a diabetic. When I got the PRE dx I pulled them back out and they consistently ranked at the highest level. Remarked to my doctor several times, concerned, and he told me if I were in a ketoacidosis state I would be very, very sick with extremely high glucose levels and that was not the case. He said I simply was not eating enough in general and especially carbs. (of course eating more carbs scares me). He said I was putting myself in a starvation mode. I probably am even though what I do eat is healthy.

Everyone I know who has been overweight and gone on one of the popular low carb diets and followed it strictly have lost significant amounts of weight. I guess the jury is out and subject to argument if this is a healthy way to eat for long periods of time. What does it actually do to our metabolism when we maintain low carb all the time at an already low BMI?

lilbit, you do seem a bit stressed, though I don't know if it would affect blood sugar readings. At 5.9 it sounds like you are doing okay. Maybe just give it some time. I was diagnosed 3 years ago. For the first year my A1c dropped from 6.4 to 5.5 and I lost 30 pounds. Then it started going up again to 6.2. I was getting concerned and considered metformin but then it slowly went down and after 3 years is stable at 5.8. I haven't changed much except for for exercising at the Y. What type of exercise are you getting? The best type is muscle building as it reduces your insulin resistance.

What is your diet like? I know you have cut carbs (I allow 15-20 per meal) but do you have a fair amount of fat in your diet. A low fat diet doesn't work well for diabetics. Maybe that would help your hunger. I get a good amount of fat and don't feel hungry.

Your weight doesn't seem to be a problem to me. I am taller but my BMI is less than yours.

An extremely low C-peptide along with a positive GAD antibody test would indicate that you have either T1 or T1.5 which is, basically, slow-onset T1. If that's the case, then all the diet and exercise in the world will not continue to control your blood sugar levels and you will need insulin.

Unfortunately, many doctors still are not aware of T1.5 (which is also referred to as LADA, meaning "latent adult-onset Diabetes T1), and so they don't test for it. T1.5 can take up to 18 months or more to progress to the point where insulin is needed, and it may take that long for the GAD antibodies to show up on the test. It should, however, always be suspected when a patient is thin to begin with, continues to lose weight, is limiting carbs and exercising regularly, but their blood glucose levels continue to rise.

I know that neither you, Lilli, nor you, Lilbit, want to have to contemplate going on insulin but, if you do in fact have either T1 or T1.5, it is far, FAR better to find that out and take care of it than to ignore it and risk complications down the road. And you can also stop blaming yourselves for your numbers progressing upwards, whether you have T1, T1.5 or T2...this is NOT your fault!!!